DRUG FREE AUSTRALIA Beyond the Smoke-Screen Examining Proposals for Legalisation of Marijuana as Medicine Central Issues & Compiled Evidence DRUG FREE AUSTRALIA Five Central Issues for Australian Legislators 1. ‘Medical Marijuana’, (which is a misnomer) has been legally used in Australia since the mid-1990s, when the THC capsule developed in the US called Marinol was imported into Australia under TGA Special Access for 100 patients. Marinol can be imported today under the same arrangement. Alternatively, the whole-leaf extract of cannabis, called Sativex, was approved by the Australian TGA in 2012 for MS spasticity. Both medications are pharmaceutically standardised in terms of dosage, strength and purity, which crude cannabis products are not. A third pharmaceutical medicine which is high in CBD, Epidiolex, is currently being tested in the US and could be tested here under similar arrangements – CBD is the element within cannabis believed to be responsible for the relief of severe seizures in epilepsy-like syndromes for some sufferers. There is consequently no need to legalise crude cannabis grow-sites in Australia 2. It is not Australia’s medical establishment that is asking for crude cannabis to be used here as medicine. The push for smoked marijuana by drug legalisation lobbyists who publicly support NSW media-showcase Dan Haslan’s use of smoked cannabis for chemotherapy-induced nausea, militates against everything that calls itself ‘medical’. The harms of smoking as a delivery system are self-evident – no medicine is ever smoked Cannabinoids are not a first-line drug for any medical condition. Other legally available drugs are better for each of the few conditions which cannabinoids have been found to alleviate Various medical treatments for cancer or other ailments can be prohibitively expensive for suffering Australians, and PBS subsidies make them available to those that need them. If it is argued that pharmaceutical cannabinoids are expensive, PBS subsidies should likewise be sought according to the same criteria as other needed treatments - if it can be demonstrated that significant numbers of Australians need and would use them 1 In the most extensive scientific review of ‘medical marijuana’ to date by the US Academies of Science’s Institute of Medicine, 95% of ‘medical marijuana’ users in the US were previously recreational cannabis users. Many of the patients who are brought along to parliamentary inquiries, and who offer public testimony of the wonderful effects of cannabis are actually speaking from a background of pre-existing cannabis dependency and addiction, where cannabis alleviates many of the very conditions it itself causes, often as part of a well- documented withdrawal syndrome 3. Those working to legalise the recreational use of cannabis worldwide by seeking to destroy the United Nations’ International Drug Conventions use ‘medical marijuana’ as a Trojan horse to introduce the full legalisation of cannabis for recreational use. In one US State with ‘medical marijuana’ laws, almost 50% of young people entering treatment for cannabis addiction sourced their cannabis from people with ‘medical marijuana’ prescriptions, demonstrating that diversion to recreational users will always be a problem under such provisions 4. The harms of recreational cannabis use are so substantial and substantiated that giving any leeway to Trojan horse strategies of the drug legalisation lobby should never be contemplated. Such strategies give a green light to public mischief-making as is evidenced in those US States where crude cannabis has been approved for medical use, particularly where trafficable quantities of ‘medical cannabis’ are made available to sufferers 5. According to the 2010 National Drug Strategy Household Survey, a survey of more than 24,000 Australians, 92% of Australians do not approve the recreational use of cannabis, which is precisely what Australia21’s lobbyists are seeking to legalise. While 69% of Australians support ‘medical marijuana’ in the same study, Drug Free Australia believes very few of these Australians would be able to specify the handful of medical indications attributed to cannabis The evidence supporting each of the five central issues nominated here is found in the following pages. 2 Table of Contents FIVE CENTRAL ISSUES FOR AUSTRALIAN LEGISLATORS ...................................... 1 Compiled Evidence Pharmaceutical Cannabinoids Legally in Australia since Mid-1990s ........................ 4 MARINOL legally used since mid-1990s ............................................................................. 4 MARINOL still legal in 2014 ................................................................................................. 4 SATIVEX TGA registered in 2012 ....................................................................................... 6 EPIDIOLEX being trialled by US FDA for severe epilepsy seizures ................................... 6 Crude cannabis not medical ................................................................................................ 6 DFA gives qualified support to use of pharmaceutic cannabinoids ..................................... 7 Australia’s Medical Establishment not Seeking ‘Medical Marijuana’ ........................ 8 Medical Associations not supportive of smoked marijuana ................................................. 8 Australia21 drug legalisation lobby backing smoked cannabis, not medicos ..................... 9 Almost every international review condemns smoking as delivery system ....................... 10 Crude cannabis not possibly a medicine ........................................................................... 13 ‘Medical Cannabis’ – only a handful of demonstrated medical uses................................. 16 . and a confounding issue – it alleviates its own withdrawal symptoms ........................ 17 Side-effects limit its usefulness ......................................................................................... 18 Tables of all scientific studies on ‘medical cannabis’ from the extensive IOM review ...... 18 Cost of pharmaceutical cannabinoids may need PBS subsidy ......................................... 48 95% of ‘medical cannabis’ users are recreational users ................................................... 48 Most uses of ‘medical cannabis’ are objectively unverifiable ............................................ 52 Crude ‘Medical Cannabis’ a Trojan Horse to Legalise Recreational Use ................ 53 Drug legalisation strategies ............................................................................................... 53 Massive, trafficable quantities recommended for medical use .......................................... 54 And a green light for public mischief ................................................................................. 54 Diversion to Minors for recreational use documented ....................................................... 55 ‘Medical cannabis’ facilitating the avoidance of taxation in Colorado .............................. 56 Damning evidence against the drug legalisation lobby ..................................................... 56 Road deaths – increased consequence of adding another legal drug .............................. 60 Substantial Harms Must Keep Cannabis Use from Proliferating ............................. 61 Summary of harms ............................................................................................................ 61 DFA publication – Cannabis – suicide, schizophrenia and other ill-effects ....................... 63 92% of Australians do not Approve of Cannabis Use ............................................. 114 Cannabis use not acceptable to most Australians .......................................................... 114 DFA conjecture – most Australians ignorant of ‘medical cannabis’ background ............ 115 3 Drug Free Australia EVIDENCE CENTRAL ISSUES FOR AUSTRALIAN LEGISLATORS - 1 Pharmaceutical Cannabinoids Legally in Australia since Mid-1990s ‘Medical Marijuana’, (which is a misnomer) has been legally used in Australia since the mid-1990s, when the THC capsule developed in the US called Marinol was imported into Australia under TGA Special Access for 100 patients. Marinol can be imported today under the same arrangement. Alternatively, the whole-leaf extract of cannabis, called Sativex, was approved by the Australian TGA in 2012 for MS spasticity. Both medications are pharmaceutically standardised in terms of dosage, strength and purity, which crude cannabis products are not. A third pharmaceutical medicine which is high in CBD, Epidiolex, is currently being tested in the US and could be tested here under similar arrangements – CBD is the element within cannabis believed to be responsible for the relief of severe seizures in epilepsy-like syndromes for some sufferers. There is consequently no need to legalise crude cannabis grow-sites in Australia MARINOL legally used since mid-1990s The following text is taken from page 32 of a paper in the NSW Parliamentary Library Research Service titled ‘The Medical Use of Cannabis – Recent Developments’ by Gareth Griffith and Marie Swain (1999) which accurately reflects the legal status of Marinol, a THC capsule developed more than 30 years ago in the United States: The use of dronabinol in Australia: A 1997 paper commented that, while cannabis is not currently registered as a therapeutic agent in Australia, the synthetic cannabinoid, Marinol (the trade name under